Aflatoxin and viral hepatitis exposures in Guatemala: Molecular biomarkers reveal a unique profile of risk factors in a region of high liver cancer incidence.
Aflatoxin and viral hepatitis exposures in Guatemala: Molecular biomarkers reveal a unique profile of risk factors in a region of high liver cancer incidence.
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DOI：
10.1371/journal.pone.0189255
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Ramirez-Zea M
中科院分区：
文献类型：
--
作者：
Smith JW;Kroker-Lobos MF;Lazo M;Rivera-Andrade A;Egner PA;Wedemeyer H;Torres O;Freedman ND;McGlynn KA;Guallar E;Groopman JD;Ramirez-Zea M
肝癌是一个新兴的全球健康问题，在美国和经济发展中国家的发病率都在上升。虽然危地马拉的艾滋病发病率在西半球最高，而且男女比例为1：1，但很少有研究关注这一人群。因此，我们确定了危地马拉成年人黄曲霉毒素B1（AFB 1）暴露和肝炎病毒感染的患病率和相关性。年龄≥40岁的健康男性和女性（n = 461），居住在危地马拉的五个省，参加了2016年5月至10月的横断面研究。采用同位素稀释质谱法定量血清AFB 1-白蛋白加合物。采用多元线性回归评估AFB 1-白蛋白加合物水平与人口统计学因素之间的关系。采用免疫分析法检测B型肝炎病毒和丙型肝炎病毒感染的生物标志物，并采用Fisher精确检验进行分析。在100%的参与者中检测到AFB 1-白蛋白加合物，中位数为8.4 pg/mg白蛋白（范围，0.2-814.8）。男性、农村、低收入和受教育程度较低的参与者的暴露量显著高于女性、城市和较高社会经济地位的参与者（p<0.05）。B型和C型肝炎血清阳性率较低（分别为0.9%和0.5%）。大量的AFB 1暴露存在于危地马拉成年人，同时肝炎病毒血清阳性率低。从数量上看，AFB 1暴露与先前发现的增加亚洲和非洲肝癌风险的暴露相似。在危地马拉，减少AFB 1暴露可能会降低肝癌的发病率和死亡率，这需要进一步的研究。
Liver cancer is an emerging global health issue, with rising incidence in both the United States and the economically developing world. Although Guatemala experiences the highest rates of this disease in the Western hemisphere and a unique 1:1 distribution in men and women, few studies have focused on this population. Thus, we determined the prevalence and correlates of aflatoxin B1 (AFB1) exposure and hepatitis virus infection in Guatemalan adults. Healthy men and women aged ≥40 years (n = 461), residing in five departments of Guatemala, were enrolled in a cross-sectional study from May—October of 2016. Serum AFB1-albumin adducts were quantified using isotope dilution mass spectrometry. Multivariate linear regression was used to assess relationships between AFB1-albumin adduct levels and demographic factors. Biomarkers of hepatitis B virus and hepatitis C virus infection were assessed by immunoassay and analyzed by Fisher’s exact test. AFB1-albumin adducts were detected in 100% of participants, with a median of 8.4 pg/mg albumin (range, 0.2–814.8). Exposure was significantly higher (p<0.05) in male, rural, low-income, and less-educated participants than in female, urban, and higher socioeconomic status participants. Hepatitis B and C seropositivity was low (0.9% and 0.5%, respectively). Substantial AFB1 exposure exists in Guatemalan adults, concurrent with low prevalence of hepatitis virus seropositivity. Quantitatively, AFB1 exposures are similar to those previously found to increase risk for liver cancer in Asia and Africa. Mitigation of AFB1 exposure may reduce liver cancer incidence and mortality in Guatemala, warranting further investigation.
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影响因子：
4.3
作者：
Cupid, BC;Lightfoot, TJ;Garner, RC
通讯作者：
Garner, RC
DOI：
10.1080/19440049.2011.647098
发表时间：
2012-01-01
影响因子：
2.9
作者：
Carvajal, Magda;Berumen, Jaime;Guardado-Estrada, Mariano
通讯作者：
Guardado-Estrada, Mariano
DOI：
10.1097/meg.0000000000000164
发表时间：
2014-10-01
影响因子：
2.1
作者：
Heidrich, Benjamin;Cetindere, Ahmet;Bastuerk, Murat
通讯作者：
Bastuerk, Murat
DOI：
10.1016/j.ijheh.2015.12.003
发表时间：
2016-05-01
影响因子：
6
作者：
Jager, Alessandra V.;Tonin, Fernando G.;Oliveira, Carlos A. F.
通讯作者：
Oliveira, Carlos A. F.
影响因子：
51.1
作者：
Bray, Freddie;Jemal, Ahmedin;Forman, David
通讯作者：
Forman, David